| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,905 |
2,220 |
$162K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
530 |
436 |
$40K |
| V2020 |
Frames, purchases |
2,584 |
2,119 |
$38K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,404 |
1,135 |
$21K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,530 |
1,361 |
$18K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
433 |
356 |
$4K |
| 92285 |
|
219 |
127 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
119 |
115 |
$2K |
| 92250 |
|
36 |
28 |
$705.63 |
| 92134 |
|
14 |
12 |
$181.20 |
| 92015 |
Determination of refractive state |
3,189 |
2,437 |
$0.00 |